Hepatomegaly As A Single Presenting Sign Of Stage Iv-s Neuroblastomagn Of Stage
Bujanover, Y., Hareel, A., & Burstein, Y. (1990). Hepatomegaly as a single presenting sign of stage IV-S neuroblastoma. Journal of pediatric gastroenterology and nutrition, 11(4), 545–548. https://doi.org/10.1097/00005176-199011000-00017
View Original Source →Abstract
This article presents the case of an infant who on routine physical examination at the age of 5 months was found to have hepatomegaly. The initial investigation revealed borderline liver function tests, and ultrasonography showed multiple space-occupying lesions. Further workup using different imaging techniques, urinary vanillylmandelic acid, serum catecholamines, and liver biopsy led to the diagnosis of stage IV-S neuroblastoma. No primary site outside of the liver could be demonstrated. The tumor regressed spontaneously.
Case Details
Disease Location
Hepatomegaly (stage 4 neuroblastoma)
Personal Characteristics
5.5- months-old boy
Clinical Characteristics
Diagnosed with hepatomegaly on 5 months wellness check. Ast elevated to 30 iu/ml, us confirmed enlarged liver and spleen. Tc99 colloid scan showed increased uptake in both lobes of the liver. CT scan confirmed findings. Bone scan and bone marrow aspiration normal. Liver biopsy confirmed neuroblastoma. 24hr urine vma elevated. Primary lesion could not be identified on scintigraphy scan. Managed conservatively with wait and watch.
Remission Characteristics
Repeat scan at 4 months showed remission of liver lesions as well as vma levels in urine. Repeated at 6 months which were also negative.
Treatment & Mechanisms
Proposed Remission Mechanisms
Possible spontaneous necrosis and absorpatiention vs spontaneous maturation and evolution.